Eczema

OverviewInflammation of the skin characterised by the redness and thickness, accompanied by itching. There are many types of eczema, the most common of which is atopic eczema. Usually starts in infants who grow out of it by the time they are three or four years of age. However, sensitivity to certain allergens may cause eczema to remain problematic for much longer and it would commonly be present with asthma or hay fever. There is usually a family history of this chronic eczema and can be quite distressful for the person as they can scratch quite hard to the point of tearing their skin causing bleeding and scarring.

DescriptionWhen the skin is inflamed it can lead to other complications such as infections getting in under the broken skin causing fungal infections (ringworm), viral (warts) or bacterial infections (impetigo). Skin prone to eczema can be very sensitive to many chemicals such as colours, fragrances, bleaches and preservatives found in emollients, suncreams and other topical applicants. Careful selection of these products is vital so as not to aggravate the eczema. Use a soap substitute or a bath emollient or directly onto the skin as a moisturiser, although the preservative in them may irritate some people. Keeping the skin soft is vital in prevention of secondary infections.

SymtomsAggravated eczema may require the use of topical steroids to reduce inflammation. Hydrocortisone 1% is available without prescription. Topical steroids must be applied sparingly and only when needed to reduce side affects such as thinning of the skin. Combination preparations such as betamethasone with fusidic acid may be used in case of infection. Their use must be cautious as infection may be opportunistic and can lead to impetigo. Oral flucloxacillin is commonly prescribed to reduce this risk.

TreatmentAnthistamines have a role in reducing the itching and may be of benefit especially at night. Promethazine or chlorpheniramine have sedating side effects and are of extra value at night time.

What clothes are worn against the skin can be important. Cotton is well established as an eczema friendly textile and the use of cotton under garments and shirts can give great comfort to eczema sufferers. Washing powders are also important as traces of irritant fragrances and enzymes can be found in clothes after being washed in bio-logical washing powders. Non-biological washing powders with no fragrance are preferable and the use of mechanical fabric softener (studded rubber balls) in a tumble dryer has a similar effect to a chemical softener.

Eczema sufferers quickly learn to avoid what causes aggravation ot their skin and by the time they are adults the eczema may ease off to a mere dry skin condition that needs constant moisturising.

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